Key result
In-home HEPA air purifiers lower systolic blood pressure by ~3 mm Hg vs sham filtration.
Why the study?
Does in-home HEPA filtration reduce blood pressure in adults living adjacent to highways?
RCT (n=154)
Crossover
Does in-home HEPA filtration reduce blood pressure in adults living adjacent to highways?
Answers are grounded in this paper and cite their sources.
In-home HEPA air purifiers provide clinically important reductions in systolic blood pressure for individuals with elevated baseline SBP living in environments with relatively low PM2.5 concentrations.
Particulate matter (PM) pollution is a leading cause of cardiovascular risk and illness, including elevated blood pressure (BP). The purpose of this study was to test the efficacy of in-home air purifiers to reduce BP for adults living adjacent to highways. We conducted a pragmatic randomized crossover trial of the effect of high-efficiency particulate arrestance (HEPA) vs sham filtration on BP. Residences were randomized to start with 1 month of HEPA filtration or 1 month of sham filtration. A 1-month wash out period with no filtration was followed by 1 month of the alternate filtration. Participant questionnaire data and BP were collected 4 times, at the start and end of each filtration period. PM concentrations were measured in a subset of residences. Linear mixed models were used to compare the mean change in BP between the HEPA and sham filtration periods. Models were adjusted for time invariant and time-varying covariates. A total of 154 participants were analyzed. The mean age was 41.1 years, 59.7% were women, 68.2% were non-Hispanic White, and a majority were of higher socioeconomic status. The mean baseline brachial systolic blood pressure (SBP)/diastolic BP was 118.8/76.5 mm Hg. HEPA filtration significantly reduced PM in comparison to both indoor sham and outdoor levels. Participants' SBP at the start of the intervention period moderated the efficacy of the intervention (P = 0.03). Participants who had elevated brachial SBP (≥120 mm Hg) had a significant 2.8-mm Hg mean reduction in SBP after HEPA filtration (P = 0.03) and a 0.2-mm Hg mean increase in SBP after sham filtration (P = 0.85). The net result was a significant 3.0-mm Hg mean difference in favor of HEPA filtration (P = 0.04). There was no significant benefit on diastolic BP or for participants with normal SBP (<120 mm Hg). The use of in-home HEPA air purifiers resulted in clinically important reductions in SBP for people with elevated SBP in environments with relatively low PM2.5 concentrations.
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Brugge et al. (2025) conducted an RCT in Elevated blood pressure (n=154). In-home HEPA air purifiers vs. Sham filtration was evaluated on Mean change in systolic blood pressure (MD 3.0 mm Hg, p=0.04). In-home HEPA air purifiers significantly reduced systolic blood pressure by a mean difference of 3.0 mm Hg compared to sham filtration among adults with elevated baseline SBP (P=0.04).
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